This invention relates to instruments and methods for suturing tissue, particularly for suturing abdominal (laparo) muscle tissue and the lining of the abdominal cavity following abdominal, especially laparoscopic, surgery.
In performing laparoscopic surgery, it is necessary to make an incision through several layers of tissue. They are the outer layer of skin, or epidermis, a layer of fat beneath the epidermis, a layer of abdominal muscle tissue beneath the fat and the lining of the abdominal cavity, called the peritoneum. Once the procedures within the abdomen are complete, it is necessary to close the wound resulting from the incision. This has customarily been done merely by suturing the incision through the layer of epidermis. Closure of the skin does not close the muscle or the peritoneum. While the muscle and peritoneum will eventually heal, it is possible for the intestinal and fatty contents of the cavity to protrude through the opening thereby creating a hernia. Closure of the muscle and peritoneum eliminates such risk.
Therefore, it is desirable first to suture the peritoneum and the layer of abdominal muscle and thereafter to suture the layer of epidermis. However, this is difficult to accomplish with a conventional suture needle, even a curved suture needle, because the incision in the skin is small. Exposure of the incision in the muscle requires making the skin incision several times larger, defeating the concept of minimal invasion. It is difficult to manipulate a standard needle into the edges of the underlying muscle through the small incision in the skin and underlying fat tissue.
Accordingly, there is a need for an improved medical instrument and method for suturing the abdominal muscle tissue and peritoneum at an incision therethrough.